Safety considerations in the pharmacological management of atrial fibrillation

Camm, A. John

doi:10.1016/j.ijcard.2007.11.006

Cited by 62 publications

(37 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is well described that with certain antiarrhythmic medications, most notably amiodarone, that the duration of time on the medication is associated with the complications. 9 Further, the strategy for long-term medical treatment in a patient with AF seems less palatable when the patient is under the age of 45 years and is being destined for decades of exposure to the drug.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Risk of Atrial Fibrillation Ablation Before 45 Years of Age

Leong‐Sit

Zado

Callans

et al. 2010

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

Background— Young patients with atrial fibrillation (AF) tend to be more symptomatic and less willing to take long-term medications, yet catheter ablation remains recommended as second-line therapy for AF regardless of age. This study seeks to characterize the effectiveness and risk of AF ablation in the young. Methods and Results— Consecutive (n=1548) patients who underwent 2038 AF ablation procedures were included. Major procedural complications and efficacy were analyzed on the basis of age at the initial procedure: <45 years (group 1), 45 to 54 years (group 2), 55 to 64 years (group 3), and ≥65 years (group 4). AF control was defined as no or rare AF on or off antiarrhythmic drugs. The primary outcome of AF control was similar in all groups; it was achieved in 87% in group 1, 88% in group 2, 88% in group 3, and 82% in group 4 ( P =0.06). However, more group 1 patients demonstrated freedom from AF off antiarrhythmic drugs (76%) compared with group 2 at 68%, group 3 at 65%, and group 4 at 53% ( P <0.001). There were no major complications in group 1, 10 (1.7%) in group 2, 14 (1.4%) in group 3, and 10 (2.6%) in group 4 ( P =0.01). Conclusions— In patients younger than 45 years, there is a lower major complication rate and a comparable efficacy rate, with a greater chance of being AF free without antiarrhythmic drugs. These findings suggest that it may be appropriate to consider ablative therapy as first-line therapy in this age group.

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy and Risk of Atrial Fibrillation Ablation Before 45 Years of Age

Leong‐Sit

Zado

Callans

et al. 2010

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

show abstract

“…Despite its superior efficacy, amiodarone therapy has several disadvantages, including requirement of a loading period, interactions with many other drugs, and, most important, serious extracardiac side effects, such as thyroid dysfunction, pulmonary toxicity, and hepatic toxicity. 3,4 Considerable experimental and clinical evidence suggest that POAF is multifactorial. Facilitating factors can be classified as acute factors caused by the surgical intervention (inflammation) and chronic factors related to structural heart disease.…”

mentioning

confidence: 99%

Clinical efficacy of epicardial application of drug-releasing hydrogels to prevent postoperative atrial fibrillation

Wang

Mei

Yuan

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

View full text Add to dashboard Cite

show abstract

“…This can be prevented in a substantial percentage of patients by using long-term amiodarone therapy [4][5][6]. However, amiodarone treatment is associated with significant side effects, including hyperthyroidism or hypothyroidism, pulmonary and hepatic toxicity, and neurological symptoms, which may preclude the benefits of this approach [7,8]. These side effects are much more frequent after long-term treatments.…”

Section: Introductionmentioning

confidence: 99%